OrganizationMd @ Home Illinois, Sc(<Unavail>)Internal MedicineAllopathic & Osteopathic PhysiciansPractice Address2003 W Fulton St Ste 303, Chicago, IL 60612-2345(312) 243-2223PECOS EnrollmentBased on the most recent information from CMS, provider Md @ Home Illinois, Sc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1568758415Provider TypeOrganizationFull NameMd @ Home Illinois, ScOther Name<Unavail>SubpartNoEnumeration Date6/20/2011Last Updated12/28/2022Contact InformationPractice LocationPractice Address2003 W Fulton St Ste 303, Chicago, IL 60612-2345Phone(312) 243-2223Fax(312) 243-2227Mailing LocationMailing Address2003 W Fulton St Ste 303, Chicago, IL 60612-2345Phone(312) 243-2223Fax(312) 243-2227Authorized OfficialNameHall, Sue (Director Of Operations)Phone(312) 243-2223Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerIllinois